Individual
DR. JEREMY ELLIOTT KASLOW
Active
Individual
DR. JEREMY ELLIOTT KASLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
G55911
CA
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
G55911
CA
2080P0201X
Pediatric Allergy/Immunology Physician
G55911
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33-0428376
FEIN
CA
01
—
82-0877333
FEIN
CA
01
—
G55911
CALIFORNIA STATE LICENSE
CA
Enumeration date
10/25/2006
Last updated
08/06/2024
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